They write that the economic burden results from the out-of-pocket costs of treatment, the costs of self-management such as home modifications and transport, and the loss of income for patients and carers.

The authors wrote that poverty and poor health are part of a cycle, such that poor health leads to poverty, which then leads to poor health.

In Australia, out-of-pocket costs of treatment are high compared with other developed countries. A survey of 11 high-income countries found that Australia's out-of-pocket medical costs were the third highest, with 21 percent of respondents having spent more than US$1000 on treatment in the previous year.

Additionally, of 28,665 Australians who became bankrupt in 2009, 11 percent cited ill health or absence of health insurance as the primary reason.

"The available evidence indicates that the out-of-pocket costs of treatment and self-management and loss of income from chronic illness and disability are associated with economic hardship, catastrophic health care spending and non-compliance with medical treatment", the authors wrote.

The proposed National Disability Insurance Scheme is a significant reform that may help address this problem in the long term. In the short term, targeted interventions such as income support and subsidies can provide some relief to those at risk of illness- and disability-related economic hardship.

"If you're struggling to pay rent or make mortgage repayments, you may be more likely to stop using medications or see your doctor less regularly, which may make your condition worse and leave you even more economically vulnerable."

The Medical Journal of Australia is a publication of the Australian Medical Association. A senior health economist today called for a mix of policy reform and targeted support to relieve the burden of 'catastrophic' health care spending incurred by chronically-ill and disabled Australians and their families.